HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) - US Realm, published by HL7 International / Public Health. This guide is not an authorized publication; it is the continuous build for version 2.1.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/case-reporting/ and changes regularly. See the Directory of published versions

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• Detailed Descriptions
• Mappings
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Resource Profile: eICR Encounter

This Encounter profile represents the encounter related to the event. It is based on the US Public Health Encounter profile.

Usage:

• Refer to this Resource Profile: Electronic Initial Case Report Composition and RR Composition
• Examples for this Resource Profile: Encounter/encounter-eicr-eve-everywoman-completed-inpatient, Encounter/encounter-eicr-eve-everywoman-current-inpatient and Encounter/encounter-eicr-eve-everywoman-outpatient

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from USPublicHealthEncounter

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USPublicHealthEncounter	eICR Encounter
identifier	S	1..1	Identifier	Identifier(s) by which this encounter is known
period		1..1	Period	The start and end time of the encounter
start	S	1..1	dateTime	Starting time with inclusive boundary
diagnosis	S	0..*	BackboneElement	Encounter diagnosis
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
sliceEncounterDiagnosisTrigger	S	0..1	(Complex)	Trigger Code Flag URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USPublicHealthEncounter	eICR Encounter
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
subject	SΣ	1..1	Reference(US Public Health Patient)	The patient or group present at the encounter
Slices for participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter Slice: Unordered, Open by type:type
participant:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
participant:sliceResponsibleProvider	SΣ	0..1	BackboneElement	Responsible provider
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	Responsible provider Binding: ParticipantType (extensible): Role of participant in encounter. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ATND
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	1..1	Reference(US Public Health PractitionerRole)	Responsible Provider
period	S	1..1	Period	The start and end time of the encounter
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..1	Reference(US Core Condition Profile)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	Encounter diagnosis
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
sliceEncounterDiagnosisTrigger	S	0..1	(Complex)	Trigger Code Flag URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(US Public Health Condition)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	1..*	BackboneElement	Public health encounter location
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(US Public Health Location)	Location the encounter takes place
serviceProvider	S	0..1	Reference(US Public Health Organization)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.identifier.use	required	IdentifierUse
Encounter.status	required	EncounterStatus
Encounter.class	extensible	ActEncounterCode
Encounter.type	extensible	USCoreEncounterType
Encounter.participant.type	extensible	ParticipantType
Encounter.participant:sliceResponsibleProvider.type	extensible	Pattern: ATND
Encounter.reasonCode	preferred	EncounterReasonCodes
Encounter.diagnosis.use	preferred	DiagnosisRole
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USPublicHealthEncounter	eICR Encounter
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(US Public Health Patient)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
Slices for participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter Slice: Unordered, Open by type:type
participant:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | RelatedPerson)	Persons involved in the encounter other than the patient
participant:sliceResponsibleProvider	SΣ	0..1	BackboneElement	Responsible provider
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	Responsible provider Binding: ParticipantType (extensible): Role of participant in encounter. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ATND
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	1..1	Reference(US Public Health PractitionerRole)	Responsible Provider
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	1..1	Period	The start and end time of the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..1	Reference(US Core Condition Profile S | US Core Procedure Profile | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	Encounter diagnosis
id		0..1	string	Unique id for inter-element referencing
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
sliceEncounterDiagnosisTrigger	S	0..1	(Complex)	Trigger Code Flag URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(US Public Health Condition)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	1..*	BackboneElement	Public health encounter location
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(US Public Health Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider	S	0..1	Reference(US Public Health Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse
Encounter.identifier.type	extensible	Identifier Type Codes
Encounter.status	required	EncounterStatus
Encounter.statusHistory.status	required	EncounterStatus
Encounter.class	extensible	ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode
Encounter.type	extensible	USCoreEncounterType
Encounter.serviceType	example	ServiceType
Encounter.priority	example	ActPriority
Encounter.participant.type	extensible	ParticipantType
Encounter.participant:sliceResponsibleProvider.type	extensible	Pattern: ATND
Encounter.reasonCode	preferred	EncounterReasonCodes
Encounter.diagnosis.use	preferred	DiagnosisRole
Encounter.hospitalization.admitSource	preferred	AdmitSource
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator
Encounter.hospitalization.dietPreference	example	Diet
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition
Encounter.location.status	required	EncounterLocationStatus
Encounter.location.physicalType	example	LocationType

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USPublicHealthEncounter

Summary

Mandatory: 3 elements
Must-Support: 5 elements

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension

Differential View

This structure is derived from USPublicHealthEncounter

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USPublicHealthEncounter	eICR Encounter
identifier	S	1..1	Identifier	Identifier(s) by which this encounter is known
period		1..1	Period	The start and end time of the encounter
start	S	1..1	dateTime	Starting time with inclusive boundary
diagnosis	S	0..*	BackboneElement	Encounter diagnosis
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
sliceEncounterDiagnosisTrigger	S	0..1	(Complex)	Trigger Code Flag URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USPublicHealthEncounter	eICR Encounter
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	Identifier(s) by which this encounter is known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
subject	SΣ	1..1	Reference(US Public Health Patient)	The patient or group present at the encounter
Slices for participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter Slice: Unordered, Open by type:type
participant:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile)	Persons involved in the encounter other than the patient
participant:sliceResponsibleProvider	SΣ	0..1	BackboneElement	Responsible provider
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	Responsible provider Binding: ParticipantType (extensible): Role of participant in encounter. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ATND
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	1..1	Reference(US Public Health PractitionerRole)	Responsible Provider
period	S	1..1	Period	The start and end time of the encounter
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..1	Reference(US Core Condition Profile)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	Encounter diagnosis
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
sliceEncounterDiagnosisTrigger	S	0..1	(Complex)	Trigger Code Flag URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(US Public Health Condition)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	1..*	BackboneElement	Public health encounter location
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(US Public Health Location)	Location the encounter takes place
serviceProvider	S	0..1	Reference(US Public Health Organization)	The organization (facility) responsible for this encounter
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.identifier.use	required	IdentifierUse
Encounter.status	required	EncounterStatus
Encounter.class	extensible	ActEncounterCode
Encounter.type	extensible	USCoreEncounterType
Encounter.participant.type	extensible	ParticipantType
Encounter.participant:sliceResponsibleProvider.type	extensible	Pattern: ATND
Encounter.reasonCode	preferred	EncounterReasonCodes
Encounter.diagnosis.use	preferred	DiagnosisRole
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Encounter		0..*	USPublicHealthEncounter	eICR Encounter
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	1..1	Identifier	Identifier(s) by which this encounter is known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
statusHistory		0..*	BackboneElement	List of past encounter statuses
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
status		1..1	code	planned | arrived | triaged | in-progress | onleave | finished | cancelled + Binding: EncounterStatus (required): Current state of the encounter.
period		1..1	Period	The time that the episode was in the specified status
class	SΣ	1..1	Coding	Classification of patient encounter Binding: ActEncounterCode (extensible): Classification of the encounter.
classHistory		0..*	BackboneElement	List of past encounter classes
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
class		1..1	Coding	inpatient | outpatient | ambulatory | emergency + Binding: ActEncounterCode (extensible): Classification of the encounter.
period		1..1	Period	The time that the episode was in the specified class
type	SΣ	1..*	CodeableConcept	Specific type of encounter Binding: US Core Encounter Type (extensible): Valueset to describe the Encounter Type
serviceType	Σ	0..1	CodeableConcept	Specific type of service Binding: ServiceType (example): Broad categorization of the service that is to be provided.
priority		0..1	CodeableConcept	Indicates the urgency of the encounter Binding: ActPriority (example): Indicates the urgency of the encounter.
subject	SΣ	1..1	Reference(US Public Health Patient)	The patient or group present at the encounter
episodeOfCare	Σ	0..*	Reference(EpisodeOfCare)	Episode(s) of care that this encounter should be recorded against
basedOn		0..*	Reference(ServiceRequest)	The ServiceRequest that initiated this encounter
Slices for participant	SΣ	0..*	BackboneElement	List of participants involved in the encounter Slice: Unordered, Open by type:type
participant:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	0..*	CodeableConcept	Role of participant in encounter Binding: ParticipantType (extensible): Role of participant in encounter.
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	0..1	Reference(US Core Practitioner Profile S | US Core PractitionerRole Profile | RelatedPerson)	Persons involved in the encounter other than the patient
participant:sliceResponsibleProvider	SΣ	0..1	BackboneElement	Responsible provider
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	SΣ	1..1	CodeableConcept	Responsible provider Binding: ParticipantType (extensible): Role of participant in encounter. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v3-ParticipationType
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: ATND
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
period	S	0..1	Period	Period of time during the encounter that the participant participated
individual	SΣ	1..1	Reference(US Public Health PractitionerRole)	Responsible Provider
appointment	Σ	0..*	Reference(Appointment)	The appointment that scheduled this encounter
period	S	1..1	Period	The start and end time of the encounter
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Starting time with inclusive boundary
end	ΣC	0..1	dateTime	End time with inclusive boundary, if not ongoing
length		0..1	Duration	Quantity of time the encounter lasted (less time absent)
reasonCode	SΣ	0..*	CodeableConcept	Coded reason the encounter takes place Binding: EncounterReasonCodes (preferred): Reason why the encounter takes place.
reasonReference	SΣ	0..1	Reference(US Core Condition Profile S | US Core Procedure Profile | Observation | ImmunizationRecommendation)	Reason the encounter takes place (reference)
diagnosis	SΣ	0..*	BackboneElement	Encounter diagnosis
id		0..1	string	Unique id for inter-element referencing
Slices for extension	S	0..*	Extension	Extension Slice: Unordered, Open by value:url
sliceEncounterDiagnosisTrigger	S	0..1	(Complex)	Trigger Code Flag URL: http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
condition	SΣ	1..1	Reference(US Public Health Condition)	The diagnosis or procedure relevant to the encounter
use	S	0..1	CodeableConcept	Role that this diagnosis has within the encounter (e.g. admission, billing, discharge …) Binding: DiagnosisRole (preferred): The type of diagnosis this condition represents.
rank		0..1	positiveInt	Ranking of the diagnosis (for each role type)
account		0..*	Reference(Account)	The set of accounts that may be used for billing for this Encounter
hospitalization	S	0..1	BackboneElement	Details about the admission to a healthcare service
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
preAdmissionIdentifier		0..1	Identifier	Pre-admission identifier
origin		0..1	Reference(Location | Organization)	The location/organization from which the patient came before admission
admitSource		0..1	CodeableConcept	From where patient was admitted (physician referral, transfer) Binding: AdmitSource (preferred): From where the patient was admitted.
reAdmission		0..1	CodeableConcept	The type of hospital re-admission that has occurred (if any). If the value is absent, then this is not identified as a readmission Binding: hl7VS-re-admissionIndicator (example): The reason for re-admission of this hospitalization encounter.
dietPreference		0..*	CodeableConcept	Diet preferences reported by the patient Binding: Diet (example): Medical, cultural or ethical food preferences to help with catering requirements.
specialCourtesy		0..*	CodeableConcept	Special courtesies (VIP, board member) Binding: SpecialCourtesy (preferred): Special courtesies.
specialArrangement		0..*	CodeableConcept	Wheelchair, translator, stretcher, etc. Binding: SpecialArrangements (preferred): Special arrangements.
destination		0..1	Reference(Location | Organization)	Location/organization to which the patient is discharged
dischargeDisposition	S	0..1	CodeableConcept	Category or kind of location after discharge Binding: DischargeDisposition (example): Discharge Disposition.
location	S	1..*	BackboneElement	Public health encounter location
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
location	S	1..1	Reference(US Public Health Location)	Location the encounter takes place
status		0..1	code	planned | active | reserved | completed Binding: EncounterLocationStatus (required): The status of the location.
physicalType		0..1	CodeableConcept	The physical type of the location (usually the level in the location hierachy - bed room ward etc.) Binding: LocationType (example): Physical form of the location.
period		0..1	Period	Time period during which the patient was present at the location
serviceProvider	S	0..1	Reference(US Public Health Organization)	The organization (facility) responsible for this encounter
partOf		0..1	Reference(Encounter)	Another Encounter this encounter is part of
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code
Encounter.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
Encounter.identifier.use	required	IdentifierUse
Encounter.identifier.type	extensible	Identifier Type Codes
Encounter.status	required	EncounterStatus
Encounter.statusHistory.status	required	EncounterStatus
Encounter.class	extensible	ActEncounterCode
Encounter.classHistory.class	extensible	ActEncounterCode
Encounter.type	extensible	USCoreEncounterType
Encounter.serviceType	example	ServiceType
Encounter.priority	example	ActPriority
Encounter.participant.type	extensible	ParticipantType
Encounter.participant:sliceResponsibleProvider.type	extensible	Pattern: ATND
Encounter.reasonCode	preferred	EncounterReasonCodes
Encounter.diagnosis.use	preferred	DiagnosisRole
Encounter.hospitalization.admitSource	preferred	AdmitSource
Encounter.hospitalization.reAdmission	example	Hl7VSReAdmissionIndicator
Encounter.hospitalization.dietPreference	example	Diet
Encounter.hospitalization.specialCourtesy	preferred	SpecialCourtesy
Encounter.hospitalization.specialArrangement	preferred	SpecialArrangements
Encounter.hospitalization.dischargeDisposition	example	DischargeDisposition
Encounter.location.status	required	EncounterLocationStatus
Encounter.location.physicalType	example	LocationType

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	Encounter	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Encounter	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Encounter	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Encounter	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from USPublicHealthEncounter

Summary

Mandatory: 3 elements
Must-Support: 5 elements

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension

Other representations of profile: CSV, Excel, Schematron